In free-motion machine embroidery, embroidered designs are created by using a basic zigzag sewing machine. As this type of machine is used primarily for tailoring, it lacks the automated features of a specialized machine.

To create free-motion machine embroidery, the embroiderer runs the machine and skillfully moves tightly hooped fabric under the needle to create a design. The "feed dogs" or machine teeth are lowered or covered, and the embroiderer moves the fabric manually. The embroiderer develops the embroidery manually, using the machine's settings for running stitch and fancier built-in stitches. In this way, the stitches form an image on a piece of fabric. An embroiderer can produce a filled-in effect by sewing many parallel rows of straight stitching. A machine's zigzag stitch can create thicker lines within a design or be used to create a border. Many quilters and fabric artists use a process called thread drawing (or thread painting) to create embellishments on their projects or to create textile art.

Free-motion machine embroidery can be time-consuming. Since a standard sewing machine has only one needle, the operator must pause to re-thread the machine manually for each subsequent color in a multi-color design. He or she must also manually trim and clean up loose or connecting threads after the design is completed.

As this is a manual process rather than a digital reproduction, any pattern created using free-motion machine embroidery is unique and cannot be exactly reproduced, unlike with computerized embroidery.

With the advent of computerized machine embroidery, the main use of manual machine embroidery is in fiber art and quilting projects. Though some manufacturers still use manual embroidery to embellish garments, many prefer computerized embroidery's ease and reduced costs.